Dehydration in Newborns and Infants

What Is Dehydration in Babies?

Dehydration is a common condition where there is not enough fluid in the body. Your baby's body is made up of approximately 75% water, which is a component of every cell, and is vital for temperature control and maintaining bodily functions. Each day, your child loses water through urination, bowel movements, sweating, crying, and even breathing. These fluids are replaced each time they eat. But, if your baby loses a lot of fluid, for example, due to vomiting or diarrhea, they can become dehydrated.

Signs of Dehydration in Babies

Babies can become dehydrated quickly. Parents should particularly be on the lookout for signs of this condition when their baby is sick. This is especially true when babies have diarrhea, are vomiting, overheated, and/or having difficulty feeding, such as during a nursing strike or when teething. However, note that babies can become dehydrated without any of these conditions present as well.

The most common signs of dehydration in babies include:

• Concentrated urine that looks very dark yellow or orange
• Dry lips
• Dry mouth
• Excessive sleepiness
• Irritability
• Less than six wet diapers in a 24 hour period
• No interest in taking the bottle or breastfeeding
• No tears when your baby is crying
• Sunken fontanelle (soft spot) on your baby's head

Causes

Dehydration in newborns and young infants is usually the result of not taking in enough fluids to replace what is lost in the course of the day. Older infants and children are more likely to become dehydrated from an illness than are newborns.

• Breast-feeding issues: Breastfed babies can become dehydrated if they're not latching on correctly, not breastfeeding often enough, not breastfeeding long enough at each feeding, or there's an issue with the supply of breast milk.
• Bottle-feeding issues: Bottle-fed babies may become dehydrated if they're not taking a bottle often enough or they're not taking in enough infant formula or pumped breast milk at each feeding.
• Diarrhea: If your child develops diarrhea, the loss of fluids through the bowels can be dangerous.
• Fever: A rise in your child's body temperature can cause a greater loss of fluids. Plus, babies may not take feedings as well when they have a fever.
• Overexposure to heat: High temperatures, extreme humidity, or spending too much time outdoors in the hot sun can cause sweating and the evaporation of fluids through your baby's skin.
• Refusing to eat: Babies may refuse the breast or bottle if they are in pain or not feeling well. A stuffy nose, earache, or sore throat can interfere with sucking and swallowing.
• Vomiting: When babies aren't able to keep down most of their feedings, they're losing important fluids that their body needs. Repeated vomiting can quickly lead to dehydration.

Treatment

If your baby is showing any possible signs of dehydration or you have any questions, you should call the doctor. If your baby is struggling, has prolonged or severe signs or symptoms, or you are worried, go to the emergency room. The treatment for infant dehydration depends on the cause and severity of the condition.

Severe dehydration can be a very dangerous and even life-threatening situation for your baby. Don't hesitate to contact your doctor and/or go to the emergency room if you are concerned.

At Home

If the symptoms are mild, your doctor may tell you to begin treating your child at home and continue to carefully monitor the symptoms.

• Follow the doctor's instructions if they tell you to give your baby an oral rehydration fluid such as Pedialyte. However, you should not give your baby Pedialyte, water, juice, soda, or any medication for illness, vomiting, or diarrhea without talking to your doctor first, as giving them the wrong liquid and/or amounts can worsen dehydration.
• Keep track of your baby's feedings and wet diapers.
• Move your baby to a cool place and remove excessive clothing or blankets from your child, if the temperature is very warm and your baby is overheating,
• Offer a bottle or breastfeed frequently, especially if your baby isn't taking in very much at each feeding.

At the Doctor's Office

If your baby is a newborn or a young infant under three months old, your doctor will likely want to see the baby for a check-up. If diarrhea or other illness or condition been prolonged, the doctor will likely want to see your baby regardless of age.

If you're breastfeeding, the doctor may want to check your baby's latch and breastfeeding technique. If you're breastfeeding and your baby isn't getting enough breast milk, you may be advised to consult with a lactation consultant and/or to supplement your baby with infant formula.

The doctor may instruct you to give your baby an oral rehydration fluid such as Pedialyte. The doctor will also examine your child's overall health. If the baby has an infection, the doctor may prescribe medicine to treat the illness.

At the Hospital

If the dehydration becomes severe, your child may need to go to the hospital. At the hospital, the doctor can monitor your baby's intake and output of fluids. They may also give your baby IV fluids to replace lost fluid, especially if the baby is not eating well or has severe vomiting and diarrhea. They may also prescribe medicine for your child to treat any illness or underlying cause.

Prevention

The best way to prevent dehydration is to not only know the signs and understand the causes but also know how to keep it from happening.

Feed Your Newborn Frequently

If you're bottle-feeding, offer one to three ounces of infant formula or pumped breast milk in a bottle every two to three hours. If you're breastfeeding, put your baby to your breast at least every two to three hours around the clock. Wake sleepy newborns up to breastfeed or to take their bottle if it's been more than three hours. As the weeks go on and your baby begins to take more at each feeding, they may be able to sleep longer between feedings.

Do not stop feeding your child to try to stop diarrhea or vomiting. Your baby needs extra fluids to replace what they're losing, so continue to breastfeed or bottle-feed as often as possible while your child is ill and undergoing treatment.

Monitor Wet Diapers and Weight Gain

Keep track of the number of wet diapers your baby is having each day and see your baby's doctor for regular well-baby checkups to monitor healthy weight gain.

Stay Out of Extreme Heat

Try not to take your newborn or young infant outdoors if it's very hot or humid. If you need to be outside, keep your baby in the shade and as cool as possible. Babies can also overheat inside in a hot, stuffy room or car or if they're all bundled up. Try to keep your baby comfortable and breastfeed and offer a bottle often to replace the fluids that they're losing.

Avoid Giving Water

You don't have to give your baby a bottle of water between feedings to try to prevent dehydration. Water fills the baby up and doesn't provide any nutrients. Both breast milk and infant formula provide your baby with fluid plus nutrition.

Prevent the Spread of Germs

Wash your hands often, especially before preparing your child's bottle and after changing diapers or using the bathroom. You can also remind family members and friends to wash their hands and ask them not to visit your child if they are sick, particularly when your child is a newborn and young infant.

A Word From Verywell

Babies lose body fluids during the day, but they get all the fluids they need to replace what's lost through their regular feedings. It's a natural balance. When there's a shift in that balance, a baby can easily become dehydrated. By understanding this common condition, its causes, and it's warning signs, you can try to prevent it or at least catch it early. Always check with your baby’s doctor if you see signs of dehydration or even just are concerned about their eating patterns, weight gain, or hydration level.